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Abstract: PO0242

IL-17 Levels Are Higher in Patients with AKI and Associate with Mortality and Major Adverse Kidney Events

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Collett, Jason Andrieu, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Ortiz-Soriano, Victor M., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Li, Xilong, The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Flannery, Alexander H., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Toto, Robert D., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Moe, Orson W., The University of Texas Southwestern Medical Center, Dallas, Texas, United States
  • Basile, David P., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Neyra, Javier A., University of Kentucky Medical Center, Lexington, Kentucky, United States
Background

Inflammatory markers of AKI have garnered attention for having potential to be sensitive biomarkers for AKI prognosis. We demonstrated that TH17 cells are increased in ICU patients diagnosed with AKI vs. those without AKI. The main objective of this study was to examine the association of serum IL-17 with mortality and major adverse kidney events (MAKE) in critically ill patients with and without AKI.

Methods

Multicenter prospective study of 299 critically ill patients with AKI stage 2 or above, and matched ICU patients without AKI. Blood samples were collected within 48 hours after AKI diagnosis (n=153) or within 48 hours of ICU admission in those without AKI (n=146). Serum IL-17a was measured using extremely sensitive ELISA (S-Plex technology; Meso Scale Discovery). Logistic regression was used to examine the association of IL-17 levels with hospital mortality and MAKE at 90 days post-discharge (composite of death, need of renal replacement therapy or inability to recover at least 70% of baseline eGFR).

Results

Patients in the highest tertile of IL-17 were more severely ill than those in lower tertiles, including more frequent AKI (73% vs. 47% vs. 33.3%, p <0.001), more frequent mechanical ventilation (63% vs. 48% vs. 44.4%, p=0.021), and higher APACHE-II scores (19 vs. 15.5 vs. 14, p<0.001). Moreover, patients in the highest tertile of IL-17 had higher rates of inpatient mortality (26% vs. 8% vs. 9.1%, p<0.001) and MAKE-90. In multivariable models, patients in the highest tertile (vs. lowest tertile) had increased risk of hospital mortality (aOR 2.80, 95%CI 1.09-7.20) and MAKE-90 (aOR 3.51, 95%CI 1.72-7.14). Concordant results were obtained when IL-17 was analyzed as a continuous variable.

Conclusion

Higher levels of IL-17 during acute illness were independently associated with hospital mortality and MAKE-90 in critically ill patients with and without AKI. Further studies are needed to validate the use of IL-17 as a surrogate pathobiologic and prognostic marker in this susceptible population.

Funding

  • NIDDK Support